Asthma is the most common chronic illness in childhood and its prevalence as well as its morbidity and mortality are increasing in the United States. Inaccurate perception of symptom severity is believed to be a major reason for delays in the treatment of asthma, contributing to morbidity and mortality. The study, Symptom Monitoring in Childhood Asthma: A Clinical Trial, is designed to: a) assess the effects of three different intensities of symptom monitoring by children with asthma and their families on physiological, functional, psychosocial, and health care utilization outcomes, and b) to describe the symptom monitoring experiences of subjects and their subsequent adherence to the monitoring strategy. Two complementary methodological approaches will be used to achieve the aims of the proposed research. The study consists of a randomized clinical trial to evaluate the effects of the different intensities of pulmonary monitoring for children with asthma, and a descriptive study of the monitoring experiences of the family. Specifically, the research aims are to compare three groups of children with asthma (those who receive twice daily objective pulmonary monitoring with a home peak flow meter, those who receive monitoring only at symptomatic times, either objective with a peak flow meter or subjective symptom evaluation) with regard to clinical outcomes, health care utilization and quality of life; and 2) to describe the background characteristics of patients/families, their symptom monitoring experiences, and subsequent adherence to the monitoring strategies, including the reasons given for adherence and non-adherence with the monitoring strategy. Analysis of the clinical trial data will be a repeated measure analysis comparing pre and post-intervention physiological, functional, quality of life, and health care utilization outcomes. Descriptive data will include both parents' and children's perceptions of the monitoring experience and their knowledge and subsequent behaviors around adherence with the proposed monitoring strategy.